Sunday, July 1, 2012

Play Therapy

Play is a child’s natural means of communication (Landreth, 2002). Developmentally, children understand and process information in a different way than adults. Children think about the ways of the world in a magical way, a rigid way, and a limited way based on their interactions in the environment and how things appear to them at the time. They cannot express certain complicated emotions through words because they haven’t mastered abstract reasoning. Words are abstract because they are made up of symbols, whereas play is a concrete experience they are familiar with. Because children lack the ability to communicate clearly through words, play is a more comfortable medium that can help bridge the gap between their concrete experiences and abstract thoughts.

Play therapy offers a safe place for children to work through difficulties they are experiencing in their life without the threat of real-life consequences. Children organize their experiences, express feelings, and explore fantasies in their world without the worry of judgment. They express and explore their self through play to reveal what they’ve experienced in the past, how they’ve reacted to these experiences, what they’ve felt about these experiences, and ultimately what they need, want or wish to come of it. This feeling of control helps children grow, mature, and develop in a way that is not always possible in their real life experiences. Many times we have little control in our daily lives (especially children), but if we can learn to utilize our own inner resources we can develop security to use in the future.

The therapist provides a different type of relationship with the child than they are used to, one that focuses on facilitating the inner growth of the child. The therapist has deep empathy, unconditional positive regard (such as warmth, acceptance, etc.) and congruence. This is shown through kindness, patience, understanding, respect, and confidence in the child. The therapist uses a multitude of verbal responses to show the child they are interested and accepting of the child’s behaviors, validate and clarify the child’s perceptions of their experiences, help children become aware of emotions through reflecting feeling, facilitate decision making, encourage freedom of expression, and use esteem-building statements to help children experience themselves as capable (Ray, 2011). In the presence of these qualities the playroom becomes a place where children will show what they feel through the toys, through what they do in the playroom, and through the stories acted to get them out in the open to be faced. The relationship between the child and therapist becomes the technique for fostering change and understanding.

Human beings are motivated to preserve their current state of being and have the desire to enhance themselves. As children use play to explore and express themselves, their own perspective of the world emerges. Children are the experts on themselves, and it is the therapist’s job is to assist them in finding the answers they are seeking inside of them. The emphasis moves away from a therapist telling a child what to do, and instead empowers the child to become more self-aware through the playing out of their inner world. No one can know as much about any human being’s inner world as much as themselves.

The child dictates the pace and nature of our work, which in turn protects the child’s autonomy in the role of the engineer of the session. Children in play therapy do not establish specific goals for themselves; the therapist trusts their capacity to discover their own strengths. Play therapy helps children know and accept themselves by developing positive self-concepts, greater self-responsibility, increased reliance on themselves, and decision-making skills. A child must have self-understanding before they can respect and appreciate the differences of others. Constructive change occurs when children are empowered. Additionally, active involvement from caregivers is vital to seeing the whole child and situational concerns that might arise.

Bratton, Ray, and Rhine (2005) identified the need for finding effective treatments for children suffering from emotional and behavioral disorders. There are long-term consequences resulting from untreated childhood disorders that not only affect the individual throughout their lifespan, but also become a larger cost to society (Bratton et al., 2005). Play therapy is a responsive technique that takes into account a child’s developmental needs, but has not gained widespread acceptance as a practical treatment due to the small sample sizes of studies (Bratton et al., 2005). This article sought to use a meta-analytic review to produce an overall treatment effect by combining the results from ninety-three play therapy outcome studies over the last fifty years of research (Bratton et., 2005).

Their analysis proved play therapy to be a statistically viable intervention that further concluded with humanistic approaches yielding higher outcomes than non-humanistic treatments (Bratton, Ray, and Rhine, 2005). However, many of the studies lacked specificity and details that limited the relationship between treatment variables and treatment outcomes (Bratton et al., 2005). Play therapy does demonstrate effectiveness in children’s behaviors, social adjustment, and personality (Bratton et al., 2005). Additionally, increasing the number of sessions increases the efficacy of play therapy, yielding more intrinsic results rather than quick symptomatic changes (Bratton et al., 2005). Also, parent involvement increased the positive outcome of play therapy by including more components of a child’s system, with filial therapy having a high effectiveness in working to change the parent child relationship (Bratton et al., 2005). Since most research on play therapy uses a design where groups either receive play therapy or no intervention at all, there is still a need to compare its effectiveness with other child treatments (Bratton et al., 2005).

References

Bratton, S. C., Ray, D. C., & Rhine T. (2005). The efficacy of play therapy with children: A meta-analysis of treatment outcomes. Professional Psychology: Research and Practice 36(4), 376-390.

Landreth, G. L. (2002). Play therapy, the art of the relationship. New York, NY: Routledge.

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Jaclyn N. Sepp

School Counselor, MA, LPC, RPT, NCC

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K-12 Certified Professional School Counselor; Licensed Professional Counselor; Registered Play Therapist, Nationally Certified Counselor; Member of Texas Counseling Association, Association for Play Therapists, & American School Counseling Association